Journal of Rehabilitation Neurosciences
Online ISSN : 2434-2637
Print ISSN : 2434-2629
Clinical Note in Japanese
Improvement of activities of daily living in a patient with bilateral medullary infarction: A case report
Takuya YADA Tsubasa KAWASAKI
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JOURNAL OPEN ACCESS

2020 Volume 20 Issue JPN Pages 38-41

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Abstract

Abstract: Bilateral infarction of the medial medulla is rare, and few reports have described its prognosis and detailed clinical findings. This case report describes a 40-year-old male patient with bilateral infarction of the medial medulla who underwent rehabilitation and subsequently showed satisfactory improvement in motor function. The patient reported his difficulty in moving his left upper and lower limbs and was then admitted to an acute care hospital the next day. On the second day of hospitalization, high intensity in the bilateral medial medulla was observed in the brain magnetic response (MR) diffusion-weighted images. Rehabilitation was started on this day. Physical therapy assessment was as follows: Brunnstrom recovery stage (BRS), VI-VI-VI/V-V-V (upper-finger-lower, right/left); scale for the assessment and rating of ataxia (SARA), 9 (walking, 3; stance, 2; sitting, 2; finger chase, 0/1; nose-finger test, 0/1; heel-shin test, 0/2 [right/left]); and Functional Independence Measure (FIM), 121. After 15 days, some motor deficits were improved (i.e., SARA, 6.5 [walking, 2; stance, 1; sitting, 2; finger chase, 0/1; nose-finger test, 0/1; heel-shin test, 0/1]; FIM, 124), but not BRS. This showed that this patient still had a mild motor deficit of the trunk and left limbs, despite his independence in activities of daily living except for going up and down the stairs.

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